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Dialysis Facility Reports, State and Region Profiles, and the Quality Incentive Program.

The Dialysis Facility Reports (DFRs) and State and Region Profiles are created annually under contract to the Centers for Medicare & Medicaid Services (CMS) to provide dialysis facilities, state surveyors, and regions with valuable information on patient characteristics, treatment patterns, hospitalization, mortality, and transplantation patterns in their facilities.

The end-stage renal disease (ESRD) Quality Incentive Program (QIP) is the first Medicare program that links provider or facility payments to performance, based on outcomes assessed through specific quality measures. These measures are important indicators of patient outcomes and at the core of medical management of ESRD patients.

What information is included in the DFRs?

The Dialysis Facility Reports include information about directly actionable practice patterns such as dose of dialysis, vascular access, and anemia management, as well as patient outcomes (such as mortality, hospitalization, and transplantation) that can be used to inform and motivate reviews of practices. The information in the report facilitates comparisons of facility patient characteristics, treatment patterns, and outcomes to local and national averages. Such comparisons help to evaluate patient outcomes and to account for important differences in the patient mix - including age, sex, race, and patients’ diabetic status - which in turn enhances each facility’s understanding of the clinical experience relative to other facilities in the state, Network, and nation.

What are the DFRs used for?

The reports are intended to be used by facilities in their quality improvement efforts. In addition, selected measures are publicly reported on the Dialysis Facility Compare website allowing dialysis patients to review and compare characteristics and quality information on dialysis facilities in the United States. State surveyors use data reported in the Dialysis Facility Reports to make decisions on which facilities to survey during the upcoming year.

Who has access to the DFRs?

The DFRs are available to patients, facilities, ESRD Networks, State Survey Agencies, and Regional Offices on the public portion of the web site. Authorized users can access the facility reports and supplements by logging in to the secure site. Dialysis facilities are encouraged to submit comments during the comment period on the secure site if they have questions or concerns regarding their reports.

Female Doctor

State and Region Profiles

State and Region Profiles are provided to the state survey agencies and CMS regional offices annually. They include maps and tables comparing state or region information as well as the Dialysis Facility Reports for every facility in the state or region. The State and Region Dialysis Profiles are available only to the corresponding State Survey Agency or CMS Regional Office. Authorized users can access the Profiles by logging into the secure site.

What is the Quality Incentive Program (QIP)?

The ESRD QIP is the first Medicare program that links any provider or facility payments to performance based on outcomes as assessed through specific quality measures. The three measures adopted for the initial year of the ESRD QIP include percentage of Medicare patients with an average Hemoglobin <10.0 g/dL, percentage of Medicare patients with an average Hemoglobin >12.0 g/dL, and percentage of Medicare patients with an average Urea Reduction Ratio (URR) >=65 percent. These measures are important indicators of patient outcomes because poor management of anemia and inadequate dialysis can lead to avoidable hospitalizations, decreased quality of life, and death. These measures are at the core of medical management of ESRD patients.

FOR DIALYSIS FACILITIES AND STATE SURVEYORS

Website Content Specified in the ESRD QIP 2014 Final Rule

In the final rule for the Payment Year (PY) 2014 End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP), the Centers for Medicare & Medicaid Services (CMS) stated they would post numerical values for the performance standards, achievement thresholds, benchmarks and minimum Total Performance Score using data from the full 12 month baseline period. These PY 2014 ESRD QIP numerical values are now available on this website.

Announcements: QIP

CMS will electronically notify facilities that the 2012 Performance Score Certificates are available for downloading in December 2011 (notification by December 15, 2011). Facilities must login to our secure site to download the certificate. Each facility is responsible for printing the Performance Score Certificate and posting it in a noticeable location where patients and caregivers can view it. PSCs must be displayed in the facility within 5 business days of being made available on the website.

For more information, see our supplemental material for providers -or- for renal networks and facilities.

Important Dates

For a detailed list of dates, click here.

Announcements: DFRs

On November 22, 2011, the Dialysis Facility Reports (DFR) were replaced with an updated version correcting an error that was recently identified. In Table 6, the categorization of the average hemoglobin has been corrected for some patients resulting in changes to the percentages reported in lines 6h, 6j, and 6l. The average hemoglobin values in line 6g are unchanged. For most affected facilities, only one patient was misclassified and therefore the changes in percentages are small. This correction does change the hemoglobin percentages that will be reported on Dialysis Facility Compare (DFC) for 152 facilities. The corrected values are shown in the DFC Preview table on page 2 of the DFR. Please note that these changes do not impact the measures reported on the Performance Score Report (PSR).

DialysisReports.org is administered by:
Arbor Research Collaborative for Health and the University of Michigan Kidney Epidemiology and Cost Center (KECC).

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